Does Your Toddler Have a Developmental Delay?

Your firstborn is a Chatty Cathy who spoke in complete sentences by 24 months. Your second kid — not so much. Her vocabulary consists of grunts and groans rather than words.

All kids are different, but this seems off. Should you add “worry about Alice” to your overflowing task list?

Talk, walk and play: Child development milestones to look for

“Development includes motor skills, language skills and social skills,” says pediatrician Minh-Y Canh, DO. “Your child may fall into a wide range of what’s considered normal, but there’s often little reason to be concerned.”

Here’s what to look for in between pediatrician appointments to know if your toddler is on track. Keep in mind: These are averages, so your child may be ahead of or behind the goal.

Language development

Your child’s pediatrician will expect your child to meet these milestones:

• 2 to 4 months: Starts to smile and laugh.
• 6 months: Starts to babble.
• 12 months: Begins to correctly associate words (for example, “Where’s the ball” and the child can look specifically at the ball).
• 15 months: Has spoken first words, and usually has about 4 to 6 in his or her vocabulary.
• 18 months: Knows basic body parts and can point to them (and possibly name them).
• 24 months: Speaks at least 50 words and some two-word phrases.

If your child has a speech delay:

The delay isn’t necessarily developmental: “Impaired hearing can cause a speech delay, so we’ll want to evaluate speech and hearing abilities,” says Dr. Canh.

Delayed speech can result in temper tantrums or behavior issues because kids have difficulty communicating their needs. Dr. Canh says speech therapy can make a big difference for these children.

Social development

Your child’s pediatrician will expect your child to meet these milestones:

• Before 2 months: May start to smile.  
• 2 to 4 months: Starts to laugh.
• 6 months: Might smile at themselves in the mirror.
• 9 months: Might show signs of stranger anxiety.
• 12 months: Points to things they want.
• 18 to 24 months: Makes eye contact and plays alongside another child without interacting (parallel play).
• 24 months and beyond: Plays with other kids and shares (some of the time).

If your child has a social delay:

See the big picture. Dr. Canh urges parents, day care providers and preschool teachers to look at the child holistically: “If a baby was kept at home and didn’t have much exposure to other children, they may not interact much when they enter day care or preschool,” she says. “They’re not lacking social skills — they just haven’t learned how to interact with kids. Or they may have a little anxiety they’ll need to overcome.”

In some cases, a child doesn’t socialize well at day care or preschool because they have delayed speech and can’t effectively communicate. Once again, speech therapy can come to the rescue. “Speech therapy goes a long way to helping children build social skills,” says Dr. Canh.

Motor skills development

Your child’s pediatrician will expect your child to meet these milestones:

• 6 months: Begins to roll over and sit with support.
• 9 months: Sits without assistance and begins scooting, reaching or crawling.
• 15 months: Walks (keep in mind some toddlers have no developmental delays but don’t have enough opportunity to practice their skills because Grandma carries them around all day).

If your child has a motor skills delay:

Your child’s pediatrician will make recommendations to improve motor development — such as encouraging Grandma to let your kiddo explore more with crawling and sitting. Your child may also receive a referral to an occupational or physical therapist to work on fine motor skills (holding a spoon) or gross motor skills (walking).

Early intervention thwarts developmental delays

“Early intervention and practice make a remarkable difference in helping kids reach future milestones. If necessary, we can also refer you to a developmental-behavioral pediatrician for an in-depth evaluation.”

When children are young, their brains are pliable so they can learn a lot, very quickly. Pediatricians want to stay ahead of the concern rather than addressing something at a later date when it’s more difficult to catch up. 

“At your well visit, your child’s doctor will offer anticipatory guidance, which means we let you know what to look for between now and the next appointment,” says Dr. Canh. “If something worries you before your next visit, reach out to your pediatrician. We want to hear your concerns and talk to you to make a plan.”